钆塞酸二钠增强磁共振成像在肝细胞癌检测中的应用：一项荟萃分析。

Gadoxetic acid disodium-enhanced magnetic resonance imaging for the detection of hepatocellular carcinoma: a meta-analysis.

机构信息

Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan province, China.

出版信息

PLoS One. 2013 Aug 15;8(8):e70896. doi: 10.1371/journal.pone.0070896. eCollection 2013.

OBJECTIVE

To determine the accuracy of MR imaging with gadoxetic acid disodium (Gd-EOB-DTPA) for the detection of hepatocelluar carcinoma (HCC).

MATERIALS AND METHODS

A systematic search was performed in PUBMED, EMBASE, Web of Science, Cochrane Library and the Chinese Biomedical Literature Database up to March 2013 to identify studies about evaluation of Gd-EOB-DTPA enhanced MR imaging in patients suspected of having HCC. The data were extracted to perform heterogeneity test and threshold effect test and to calculate sensitivity, specificity, diagnostic odds ratio, predictive value, and areas under summary receiver operating characteristic curve (AUC).

RESULTS

From 601 citations, 10 were included in the meta-analysis. The methodological quality of the 10 studies was good. Overall HCC: There was significant heterogeneity in the pooled analysis (I(2) = 69.4%, P = 0.0005), and the pooled weighted values were determined to be sensitivity: 0.91 (95% confidence interval (CI): 0.89, 0. 93); specificity: 0.95 (95% CI: 0.94, 0.96); diagnostic odds ratio: 169.94 (95% CI: 108.84, 265.36); positive likelihood ratio: 15.75 (95% CI: 7.45, 33.31); negative likelihood ratio: 0.10 (95% CI: 0.06, 0.15). The AUC was 0.9778. HCC in cirrhosis: The estimates were to be sensitivity: 0.91 (95% CI: 0.88, 0.93); specificity: 0.93 (95% CI: 0.89, 0.95); diagnostic odds ratio: 234.24 (95% CI: 33.47, 1639.25); positive likelihood ratio: 15.08 (95% CI: 2.20, 103.40); negative likelihood ratio: 0.08 (95% CI: 0.03, 0.21). The AUC was 0.9814. ≤20 mm HCC: The AUC was 0.9936. There was no notable publication bias.

CONCLUSIONS

This meta-analysis suggests that MR imaging with Gd-EOB-DTPA has high diagnostic accuracy for the detection of HCC, especially for ≤20 mm HCC. This technique shows good prospect in diagnosis of HCC.

目的

评估钆塞酸二钠（Gd-EOB-DTPA）磁共振成像在肝细胞癌（HCC）检测中的准确性。

材料与方法

系统检索 PUBMED、EMBASE、Web of Science、Cochrane 图书馆和中国生物医学文献数据库，查找截至 2013 年 3 月评估 Gd-EOB-DTPA 增强磁共振成像在疑似 HCC 患者中的应用价值的研究。提取数据进行异质性检验和阈值效应检验，计算敏感度、特异度、诊断比值比、阳性预测值和汇总受试者工作特征曲线下面积（AUC）。

结果

从 601 篇文献中筛选出 10 篇文献进行荟萃分析。10 项研究的方法学质量较高。整体 HCC：合并分析存在显著异质性（I²=69.4%，P=0.0005），加权敏感度为 0.91（95%可信区间：0.89，0.93），特异度为 0.95（95%可信区间：0.94，0.96），诊断比值比为 169.94（95%可信区间：108.84，265.36），阳性似然比为 15.75（95%可信区间：7.45，33.31），阴性似然比为 0.10（95%可信区间：0.06，0.15），AUC 为 0.9778。肝硬化合并 HCC：敏感度为 0.91（95%可信区间：0.88，0.93），特异度为 0.93（95%可信区间：0.89，0.95），诊断比值比为 234.24（95%可信区间：33.47，1639.25），阳性似然比为 15.08（95%可信区间：2.20，103.40），阴性似然比为 0.08（95%可信区间：0.03，0.21），AUC 为 0.9814。直径≤20 mm 的 HCC：AUC 为 0.9936。未发现明显的发表偏倚。